| NPI | 1144893785 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KEISHARA TAMECE HARRIS Owner 757-285-7922 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical |
| Additional Taxonomies | 251S00000X |
| Enumeration Date | 2021-07-21 |
| Last Update Date | 2021-11-04 |